Impression procedures in fixed prosthodontics are a critical step that determines the accuracy of the final restoration. This article focuses on conventional impression techniques using impression materials and reviews the fundamental principles of impression making, the properties of each impression material, the characteristics and selection criteria of major impression methods. It also organizes the factors that influence accuracy, together with representative clinical complications and their corresponding management strategies. Furthermore, as digital impression systems have become widespread in recent years and expanded the available options, this paper emphasizes that solid understanding of conventional techniques remains essential for foundational prosthodontic training, and provides an overview of the role and significance of these conventional methods.

Digital impression using intraoral scanners (IOS) has garnered significant attention as an innovative alternative to conventional impression techniques. This article comprehensively examines the measurement principles of IOS, characteristics of digital data, and comparative analysis with traditional methods. IOS offers numerous advantages including enhanced patient comfort, reduced chair time, and streamlined digital workflow efficiency. While IOS demonstrates accuracy comparable to or exceeding conventional methods for single crowns and small-span bridges, limitations exist in cases involving extensive edentulous spans and deep subgingival preparations. Achieving high-precision data acquisition requires systematic protocols encompassing pre-scan evaluation, thorough moisture control and gingival retraction, appropriate scanning paths, and rigorous data verification. This article addresses the clinical decision-making competencies necessary for understanding case-specific characteristics and selecting optimal impression techniques accordingly.

Dementia is a progressive condition that can occur in anyone and often makes regular dental visits and self oral care difficult. This article outlines the characteristics and major subtypes of dementia and summarizes key considerations for prosthetic treatment and oral health management based on clinical guidelines and practical experience. Prosthetic treatment is only one of several means to support the enjoyment of daily life; however, in patients with mild cognitive impairment or early-stage dementia, strategically planned prosthetic treatment with good predictability should be considered. In contrast, from the moderate stage onward, a shift from “cure-oriented” to “care-oriented” management is required, with emphasis on creating an oral environment that is easy to be managed. In addition, the benefits and risks of denture use should be carefully evaluated, and comprehensive support for quality of life should be provided, including “non-use of dentures” and the concept of “comfort feeding only.”

It is estimated that older adults with dementia or mild cognitive impairment (MCI) account for nearly 30% of the elderly population. Although individuals with dementia are unlikely to seek outpatient dental care on their own initiative, a substantial number of patients with MCI, as well as those whose cognitive function is expected to decline over time, continue to attend outpatient clinics.

Therefore, assessment of cognitive function prior to the initiation of dental treatment is considered essential. When cognitive decline is identified, it is necessary to determine—through shared decision-making involving not only the patient but also family members or legal representatives—whether invasive or long-term treatment is feasible. However, treatment decisions should not default to overly conservative approaches that may disadvantage the patient. Furthermore, as the difficulty of providing dental prosthetic treatment increases after the onset of cognitive impairment, appropriate oral management through dental visits before cognitive decline is strongly recommended.

In home-visit dental care settings, the decision of whether to undertake prosthodontic intervention cannot be resolved solely on the basis of intraoral conditions; rather, it constitutes a complex decision-making process in which the living environment, care services and support systems, and the patient's own values intersect. This paper proposes the use of the International Classification of Functioning, Disability and Health (ICF) as a framework for comprehensively organizing the issues to be examined, grounded in the principles of critical thinking. The ICF is a framework that captures body functions and structures, activities, and participation, along with environmental and personal factors, as interactive components. In home care settings in particular, the success or failure of prosthodontic intervention hinges on whether daily management tasks — such as handling, cleaning, and storing the denture — can be sustained, and whether a support system to enable this can be established. Furthermore, as an outcome (i.e., the definition of success), the value of dentures must be evaluated not only in terms of restoring the ability to eat, but also as a means of restoring social participation. At the same time, since the denture itself is not the end goal but rather a means of supporting the recovery of life functions, there are cases in which the decision not to intervene prosthodontically is the appropriate course of action. Even in such cases, the decision should not be framed as an all-or-nothing choice; instead, graded and conditional applications should also be considered. Moreover, intervention and reassessment tailored to each phase of the disease trajectory are essential, and “proactive intervention during the recovery phase with an eye toward the future maintenance phase and home care” represents a particularly important option.

By systematically organizing these elements through the ICF framework, this paper aims to contribute to improving both the quality and the explanatory power of decision-making regarding the appropriateness of prosthodontic intervention for home care patients.

Our country stands at the forefront of the super-aging society, a demographic shift that necessitates a fundamental paradigm change in implant treatment strategies. This invited literature review aimed to investigate the available scientific evidence on implant removable partial denture (IRPD) regarding treatment modalities, survival and success rates of dental implant or IRPD, marginal bone level around implant, functional parameters, oral health-related QOL, patient satisfaction, implant placement location, loading protocol, denture designs, attachment systems, biological and prosthodontic complications. In addition to previously published evidence, recent literature was surveyed based on the authors’ scoping review and systematic review on IRPDs published in 2024. Nevertheless, the currently available scientific evidence remains limited and insufficient for establishing clear and standardized treatment strategies for IRPDs. Two principal treatment modalities for IRPDs have been identified. One involves attachment systems, in which healing abutments or dedicated attachments are connected to placed implants and incorporated beneath the denture base. The other modality consists of implant-crown– or fixed partial denture–retained removable partial dentures (IC/F-RPDs), in which implant-supported surveyed crowns or fixed partial dentures function as direct or indirect abutments. Clinical application of IRPDs requires particularly careful consideration, as these prostheses create an extremely complex intraoral environment in which natural teeth, dental implants, and removable dentures coexist and interact biomechanically and biologically.

Implant removable partial denture (IRPD) have attracted attention as a treatment modality that can improve the support and stability problems associated with conventional removable partial dentures. However, clear clinical guidelines regarding case selection, treatment strategies, implant positioning, and prosthetic design for IRPDs have not yet been fully established. This article discusses key considerations for achieving long-term functional stability of IRPDs based on the author’s clinical experience and previously reported studies. Three treatment strategies are presented: a planned soft landing to implant overdentures (IODs), conversion of distal extension cases into bounded edentulous spaces by implant support, and recovery treatment utilizing existing implants. Through these strategies, the clinical significance of positioning IRPDs as part of a flexible and adaptable treatment process, rather than a definitive prosthetic solution, is highlighted.

In removable partial denture therapy, differences in displacement between abutment teeth and the residual ridge, together with the presence of a support line formed by the remaining teeth, can induce rotational displacement of the denture. Various design concepts and clinical techniques have been proposed to reduce such movement. However, adequate control remains difficult in challenging conditions such as Eichner class C1 and combination syndrome. Implant removable partial dentures (IRPD) represent an effective treatment option for these situations. Nevertheless, ideal implant placement and sufficient implant numbers are not always achievable; therefore, careful consideration must be given to implant position and attachment selection.

The increasing longevity of edentulous patients and the progressive nature of residual ridge resorption have led to a growing number of clinically challenging cases in which conventional complete denture therapy alone fails to provide adequate functional outcomes. In this article, edentulous diagnosis is redefined not merely as the presence of complete tooth loss, but as an assessment of the anticipated ability of the intraoral anatomy to support, stabilize, and retain a complete denture prosthesis, referred to as Anatomical Expectation. A diagnostic framework based on the three fundamental elements—support, stability, and retention—is reviewed, and its relevance to prosthodontic treatment planning in relation to patient expectations is discussed. Furthermore, the functional limitations of conventional complete dentures and the clinical indications for reinforcing deficient biomechanical elements through implant placement are examined. Clinical case analyses are presented to illustrate the importance of a structured diagnostic approach in selecting appropriate indications for conventional complete dentures and implant-supported prosthetic rehabilitation.

In recent years, while the overall number of edentulous patients has been decreasing, the proportion of difficult cases presenting with severe residual ridge resorption has been increasing due to population ageing and the prolonged duration of edentulism. In addition, many patients present with systemic diseases and cognitive decline, which further increases the complexity of complete denture treatment. This article aims to clarify the characteristics of difficult cases in complete denture therapy and to organize the underlying factors contributing to their complexity, as well as to discuss why the management of such cases is particularly challenging. Furthermore, key concepts for achieving functionally successful complete dentures, together with practical considerations at each clinical step, are described for cases with severe ridge resorption and unstable mandibular positions.

In implant prosthodontics for edentulous patients, treatment options generally include implant overdentures and fixed implant-supported prostheses. However, standardized criteria governing the selection, combination, and indications of these approaches remain unclear. Recent evidence indicates that implant therapy in older adults yields clinical outcomes that are by no means unfavorable, suggesting that age alone should not preclude implant-based rehabilitation. In this study, we present a series of cases involving elderly edentulous patients treated with implant-assisted strategies beyond conventional complete dentures (CD), including implant overdentures (IOD) and fixed implant prostheses (FIP). Each case is reviewed to evaluate the validity, advantages, and limitations of these treatment modalities. Through these clinical examples, we aim to clarify practical considerations and contribute to a more nuanced framework for selecting implant prosthetic strategies in the aging edentulous population.

Post-operative oral tumor patients, the primary target of maxillofacial prosthetic treatment, present complex and diverse oral environmental and functional problems due to surgical intervention. Prosthodontists must not be solely focused on the morphological change of the maxillofacial tissues, but must accurately identify the problems before selecting and designing the most appropriate devices for rehabilitation. This article will first explain the characteristics of oral environmental and functional problems and key points in examination for maxillary defect cases and mandibular (including tongue and floor of the mouth) defect cases. Next, a structured questionnaire useful for understanding the problems perceived by the patient will be introduced.

Bone-anchored devices and prostheses for wide edentulous areas, utilizing dental implants placed in residual or reconstructed bone to provide retention and support, have become an effective treatment option for patients with maxillofacial defects in whom conventional prosthetic rehabilitation is insufficient. However, this treatment modality is technically demanding and requires careful consideration to achieve favorable and predictable outcomes. Comprehensive treatment planning from the initial stage, with a clear focus on the definitive prosthesis and functional rehabilitation, is essential. In addition, close collaboration among prosthodontists, oral and maxillofacial surgeons, and other healthcare professionals is fundamental, particularly in cases requiring jaw reconstruction or perioperative management. This review outlines the indications, clinical considerations, and limitations of implant-supported maxillofacial prosthetic treatment for wide edentulous defects and highlights key points for successful implementation from the perspective of prosthodontic specialists involved in multidisciplinary team-based care.

Purpose: This network meta-analysis (NMA) aimed to evaluate the comparative effectiveness of initial conservative treatments for temporomandibular disorders (TMD), focusing on pain-related Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD).

Study Selection: A systematic search of PubMed and Embase databases was conducted for randomized controlled trials (RCTs) published between January 2000 and July 2021. Eligible studies included adults diagnosed with myalgia or arthralgia based on DC/TMD or RDC/TMD and evaluated the efficacy of conservative treatments. Twelve interventions, including stabilization splints, low-level laser therapy (LLLT), self-exercise, and placebo, were compared. Risk of bias was evaluated using Risk of Bias 2.0. MetaInsight software generated forest plots for direct comparisons, and network meta-analysis was performed standardized mean differenceing the netmeta package in R.

Results: A total of 24 RCTs comprising 1,336 participants were included in the analysis of pain outcomes, while 12 RCTs involving 614 participants evaluated maximal mouth opening (MMO). LLLT (SMD: −2.12; 95% CI: −3.18, −1.06), self-exercise (SMD: −1.51; 95% CI: −2.82, −0.2), and stabilization appliance (St-A) (SMD: −1.16; 95% CI: −2.02, −0.29) demonstrated statistically significant improvements in pain. For MMO, self-exercise (SMD: 0.71; 95% CI: −0.58, 2.01), St-A (SMD: 0.65; 95% CI: −0.09, 1.39), and LLLT (SMD: 0.63; 95% CI: −0.34, 1.6) showed promising effects. However, the certainty of evidence across outcomes was rated as very low due to methodological limitations and heterogeneity among studies.

Conclusions: Self-exercise, St-A, and low-level laser therapy show potential as effective conservative treatments in the early management of TMD. Nonetheless, the low certainty of evidence highlights the need for high-quality RCTs with standardized outcomes to strengthen clinical guidelines.

Patient: A 76-year-old female patient presented with difficulty chewing due to poor retention of her mandibular complete dentures. The mandible showed severe ridge resorption. The previous dentures exhibited mobility due to inadequate neutral zone positioning. Therefore, new dentures were fabricated using the flange technique. During fabrication, emphasis was placed on ensuring a tongue space and restoring functionality.

Discussion: Using the flange technique to establish a neutral zone and occlusal forces to the lingual side, we sought stability for the complete dentures on both the maxilla and mandible. This approach improved the patient’s chief complaint, leading to increased satisfaction and contributing to a favorable prognosis.

Conclusion: Using the flange technique, we fabricated complete dentures for both the maxilla and mandible, successfully alleviating the patient’s chief complaint.

Patient: A 55-year-old male presented with a chief complaint of dental caries; 5+5 showed faulty dental restorations and secondary caries, and 3|3 had lost their ferrule due to subgingival caries. The ferrule was regained by orthodontic extrusion of 3|3, and the anterior guidance was reconstructed after evaluation with a provisional restoration.

Discussion: The masticatory function and esthetic appearance were restored through primary splinting and occlusal scheme examination using provisional restorations, which addressed the poor crown-root ratio caused by orthodontic extrusion, and appropriate anterior guidance was established.

Conclusion: Favorable outcomes were achieved by providing appropriate anterior guidance after preserving the bilateral maxillary canines with severe caries.

Patient: A 60-year-old female presented with a chief complaint of difficulty chewing and discomfort with her dentures. The maxilla underwent bone grafting, followed by implant placement, and was restored using a full-arch implant-supported fixed prosthesis. The mandible was restored using a fixed bridge and a removable partial denture.

Discussion: Incorporating the morphology of the adjusted provisional restoration into the final superstructure in the maxilla contributed to a favorable outcome. In the mandible, maximizing the use of remaining teeth for denture stability also played a role in achieving good results.

Conclusion: The maxillary full-arch implant bridge and the mandibular fixed bridge combined with a removable partial denture resulted in a favorable prognosis.